Provider Demographics
NPI:1265692891
Name:PARKER, TERESA KAY
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:KAY
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 N LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-6972
Mailing Address - Country:US
Mailing Address - Phone:573-814-0823
Mailing Address - Fax:573-814-2863
Practice Address - Street 1:2650 N LAKELAND DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-6972
Practice Address - Country:US
Practice Address - Phone:573-814-0823
Practice Address - Fax:573-814-2863
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging